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Individual

MS. TYNIA CHILDS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
685 W BROADWAY APT 7K, MONTICELLO, NY 12701-7154
(845) 428-5554
Mailing address
55 GRASSY SPRINGS CT, OXFORD, GA 30054-3012
(470) 314-1943

Taxonomy

Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
322787
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1508176397
NY
Enumeration date
10/14/2010
Last updated
09/16/2024
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